Reproductive health risks and clinician practices with gender diverse adolescents and young adults.
Reproductive health risks and clinician practices with gender diverse adolescents and young adults.
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DOI：
10.1111/andr.13026
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发表时间：
2021-11
期刊：
影响因子：
4.5
通讯作者：
Nahata L
中科院分区：
文献类型：
--
作者：
Quinn GP;Tishelman AC;Chen D;Nahata L
生殖健康咨询对于青少年和年轻人（AYAs）至关重要。跨性别和性别多样性（TGD）AYAs将受益于量身定制的咨询，因为他们担心医源性不孕症和性功能障碍，以及人际暴力，计划外怀孕和性传播感染的高发生率，但在患者/家庭和临床医生层面提供这种护理存在多种障碍。这种叙述性综述总结了文献的生殖健康考虑TGD AYAs，目前的做法，和临床医生的障碍和促进者提供文化敏感的生殖保健TGD AYAs。具体的重点领域包括：生殖健康的目标，风险和获取障碍;临床医生的知识实践和挑战;和战略，以改善咨询的做法。使用以下术语检索PubMed、Google Scholar、Medline、Web of Science和PsycInfo数据库：transgender、non-binary、gender expanding、gender non-conforming、生殖健康、性健康、生育力、计划生育/生育、避孕、性功能障碍;性别确认激素/手术、临床医生、医生或提供者的知识和态度;咨询。许多TGD AYA渴望生物学上的孩子和改善的性体验。TGD AYA可能会经历与过渡相关的不孕症和性功能障碍;有不成比例的艾滋病毒/性传播感染风险;经历人际/性暴力和创伤的比例很高;并在获得合格的医疗保健方面遇到障碍。临床医生缺乏对TGD AYA生殖健康需求的了解;不一致地讨论家庭建设的选择;感知咨询的挑战;并希望在这方面得到更多的培训。为医疗/心理健康临床医生提供丰富的沟通培训是必要的，为TGD AYA提供熟练的劳动力。与其他人群（例如，肿瘤学）证明了提高沟通技巧和咨询信心的有效性，这篇综述强调了TGD AYAs遇到的充分生殖保健障碍，在服务不足的少数民族青年中加剧。为提供者提供专门的培训和增加获得服务的方案是改善护理的重要目标。还强调需要进行更多的研究。
Reproductive health counseling is essential for adolescents and young adults (AYAs). Transgender and gender diverse (TGD) AYAs would benefit from tailored counseling given concerns about iatrogenic infertility and sexual dysfunction, and high rates of interpersonal violence, unplanned pregnancies and sexually transmitted infections, yet there are multiple obstacles to providing this care at the patient/family and clinician levels. This narrative review summarizes the literature on reproductive health considerations for TGD AYAs, current practices, and clinician barriers and facilitators to providing culturally sensitive reproductive care for TGD AYAs. Specific areas of focus include: reproductive health goals, risks, and access barriers; clinician knowledge practices and challenges; and strategies for improving counseling practices. PubMed, Google Scholar, Medline, Web of Science, and PsycInfo databases were searched using the following terms: transgender, non-binary, gender expansive, gender non-conforming, reproductive health, sexual health, fertility, family planning/building, contraception, sexual dysfunction; gender affirming hormones/surgery, clinician, physician or provider knowledge and attitudes; counseling. Many TGD AYAs desire biological children and improved sexual experiences. TGD AYAs may experience infertility and sexual dysfunction associated with transition; have disproportionate HIV/STI risk; experience high rates of interpersonal/sexual violence and trauma; and encounter barriers to accessing competent medical care. Clinicians lack knowledge about reproductive health needs of TGD AYAs; inconsistently discuss family building options; perceive counseling challenges; and desire more training in this area. Enriched communication training for medical/mental health clinicians is necessary to provide a skilled workforce for TGD AYAs. Web-based reproductive health training with other populations (e.g., oncology) demonstrates efficacy for improving communication skills and confidence in counseling, This review highlights barriers to adequate reproductive care encountered by TGD AYAs, exacerbated in underserved minority youth. Dedicated training for providers, and programs increasing access are important goals for improving care. The need for additional research is also emphasized.
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影响因子：
7.6
作者：
Chen, Diane;Matson, Margaret;Mustanski, Brian
通讯作者：
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DOI：
10.1111/josh.12882
发表时间：
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期刊：
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